Individual
MISS GUENEVERE DIANNE LINDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5000 W SLAUGHTER LN, AUSTIN, TX 78749
(512) 654-4000
(512) 654-4001
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07859
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74874349
—
CO
Enumeration date
04/01/2010
Last updated
10/02/2020
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